Razi Journal of Medical Sciences

fa مقایسه اثربخشی درمان گروهی شناختی- رفتاری و درمان گروهی مبتنی بر پذیرش و تعهد بر تاب آوری و انعطاف‌پذیری در پرستاران زن Comparing the effectiveness of cognitive-behavioral group therapy and group therapy based on acceptance and commitment on resilience and flexibility in female nurses روانشناسی بالینی Clinical Psychiatry پژوهشي Research زمینه و هدف: پرستاری یک شغل بسیار پر از اضطراب و استرس محسوب می‌شود. میزان بالای استرس در این شغل بر سلامت جسمی و روانی پرستاران اثر می‌گذارد. لذا هدف از انجام این پژوهش مقایسه اثربخشی درمان گروهی شناختی-رفتاری و درمان گروهی مبتنی بر پذیرش و تعهد بر تاب آوری و انعطاف پذیری در پرستاران زن در رفسنجان در سال 1402 بود. روش کار: این پژوهش یک طرح نیمه آزمایشی با پیش آزمون- پس آزمون در گروه آزمایشی (درمان گروهی شناختی-رفتاری) و گروه مقایسه (درمان گروهی مبتنی بر پذیرش و تعهد) با گروه کنترل و پیگیری است. جامعه آماری آن کلیه پرستاران زن که در بیمارستان علی ابن ابیطالب شهرستان رفسنجان که در سال  1402 در این بیمارستان خدمت کرده اند، به تعداد 299 نفر بود. تعداد 45 نفر بصورت تصادفی ساده از لیست اسامی پرستاران زن انتخاب و به طور تصادفی در گروه ها ی آزمایش و گواه گماشته شدند (هر گروه 15 نفر).  ابزار پژوهش پرسشنامه تاب آوری کونور و دیویدسون (2003)  وپرسشنامه انعطاف پذیری دنیس و ونادروال 2010  بود. یافته‌ها: نتایج پژوهش با تحلیل کوواریانس نشان دادند مقایسه میزان اثرگذاری آموزش‌ها نشان می‌دهد گروه درمان گروهی شناختی-رفتاری 7/37% و گروه درمان گروهی مبتنی بر پذیرش و تعهد 1/22% اثرگذار بوده است؛ همچنین مقایسه میزان اثرگذاری آموزش‌ها نشان می‌دهد گروه درمان گروهی شناختی-رفتاری 5/32% و گروه درمان گروهی مبتنی بر پذیرش و تعهد 4/58% اثرگذار بوده است. نتیجه‌گیری: این یافته‌ها بیانگر آن است که انتخاب نوع مداخله روان‌شناختی باید بر اساس نیازهای خاص پرستاران صورت گیرد. برای افزایش تاب‌آوری، درمان شناختی-رفتاری توصیه می‌شود، درحالی‌که برای بهبود انعطاف‌پذیری، درمان مبتنی بر پذیرش و تعهد انتخاب بهتری است. پیشنهاد می‌شود برنامه‌های آموزشی و مشاوره‌ای برای پرستاران با ترکیبی از این دو رویکرد طراحی شود تا تأثیرات جامع‌تر و موثرتری بر سلامت روانی و حرفه‌ای آن‌ها داشته باشد.   <div style="text-align: justify;">Background & Aims: Nursing is considered a job full of anxiety and stress. The high level of stress in this job affects the physical and mental health of nurses. This stress is created as a result of the combination of personal factors and factors related to the work environment. Stressors in the nursing environment include closed air, time pressure, excessive noise, sudden swings from favorite tasks to routine tasks, unpleasant sights and sounds, and standing for long periods. Nurses are trained to deal with these stressful factors, but other chronic pressures such as pressures at home, conflict in the work environment, low number of employees, weak work team, insufficient training and poor supervision, role burden, incompetence, and role incompatibility. , role ambiguity, relationships with superiors, relationships with co-workers, shift work, physical factors, chemical factors, and biological factors that can increase the effect of stressors. Also, the workload, role conflicts, and the experience of aggression are other stressful factors of the nursing job, and on the other hand, jobs that are performed in shifts, such as nursing, can disrupt the 24-hour rhythm and create physiological and psychological consequences. Therefore, the purpose of this research was to compare the effectiveness of cognitive-behavioral group therapy and group therapy based on acceptance and commitment to resilience and flexibility in female nurses in Rafsanjan in 2023. Methods: This research is a semi-experimental design with pre-test-post-test in the experimental group (cognitive-behavioral group therapy) and the comparison group (group therapy based on acceptance and commitment) with control and follow-up groups. The statistical population of all female nurses who served in Ali Ibn Abi Talib Hospital in Rafsanjan city in 1402 was 299 people. 45 people were randomly selected from the list of female nurses and randomly assigned to experimental and control groups (15 people in each group). The research tools were Connor and Davidson's resilience questionnaire (2003) and Dennis and Vanaderval's 2010 flexibility questionnaire. Results: The results of the research with covariance analysis showed that the comparison of the effectiveness of the training shows that the cognitive-behavioral group therapy group was 37.7% and the acceptance and commitment-based group therapy group was 22.1% effective; Also, the comparison of the effectiveness of the training shows that the cognitive-behavioral group therapy group was 32.5% and the group therapy group based on acceptance and commitment was 58.4% effective. For the normality of the data in the cognitive-behavioral group therapy group, the group therapy group based on acceptance and commitment and the control group were checked by the Shapiro-Wilk test. According to the research results, this assumption has been met for resilience and flexibility variables (p<0.05). Also, the results showed that the variance of resilience and resilience scores in the pre-test and post-test stages in three groups of cognitive-behavioral group therapy, group therapy based on acceptance and commitment, and control have homogeneity (p<0.05). Also, according to the result of the homogeneity test of the slope of the regression line, the interaction between the covariance variable (pre-test) and the independent variable (grouping) is insignificant; Therefore, it can be said that in the cognitive-behavioral group therapy group, the group therapy group based on acceptance and commitment and control has also met this assumption (p<0.05). The results of the analysis of covariance in the grouping section (between subjects) in Table 4 show that the main effects of the group (cognitive-behavioral group therapy, group therapy based on acceptance and commitment, and control group) are significant in resilience (η=0.188). ; p-value>0.05, F=4.736); That is, the averages of resilience scores in the cognitive-behavioral group therapy group, the group therapy group based on acceptance and commitment, and the control group show a significant difference. Also, the comparison of the effectiveness of the training shows that the cognitive-behavioral group therapy group was 37.7% and the acceptance and commitment-based group therapy group was 22.1% effective; therefore, it can be said that cognitive-behavioral group therapy has had a greater effect on nurses' resilience than group therapy based on acceptance and commitment. Conclusion: These findings indicate that the type of psychological intervention should be chosen based on the specific needs of nurses. To increase resilience, cognitive-behavioral therapy is recommended, while to improve resilience, acceptance, and commitment-based therapy is a better choice. It is suggested that educational and counseling programs for nurses be designed with a combination of these two approaches to have more comprehensive and effective effects on their mental and professional health. Treatment based on commitment and acceptance is that it gives a person a chance to learn new and special skills such as reducing experiential avoidance and increasing psychological acceptance and contact with the present, and this feature makes the person not only stop avoiding but also flexible with to face it. Also, we are witnessing more use of efficient coping styles as a result of cognitive separation from these mental experiences and freedom from excessive focus on one's own personal story. When a person chooses a more efficient coping style, he subsequently endures less stress and has a more accurate perception of it. The most important problem of anxious nurses is the emotional, negative, and ineffective coping style of living in the past, so they repeatedly ruminate on the traumatic memories of the past in their minds.</div> درمان گروهی شناختی-رفتاری , درمان گروهی مبتنی بر پذیرش و تعهد , تاب آوری , انعطاف پذیری cognitive-behavioral group therapy, group therapy based on acceptance and commitment, resilience, flexibility 1 12 http://rjms.iums.ac.ir/browse.php?a_code=A-10-8148-1&slc_lang=fa&sid=1 Fatemeh Akbarinasab Hossein Abad olia فاطمه اکبری نسب حسین آباد علیا 3900319475328460090213 0009-0000-4258-8795 No Department of Psychology, Zarand Branch, Islamic Azad University, Kerman, Iran دانشجوی دکتری گروه آموزشی روانشناسی، واحد زرند، دانشگاه آزاد اسلامی، کرمان، ایران Farshid Khosropour فرشید خسروپور farshid2002@yahoo.com 3900319475328460090214 0009-0009-5964-7187 Yes Assistant Professor Department of Psychology, Zarand Branch, Islamic Azad University, Kerman, Iran استادیار گروه آموزشی روانشناسی، واحد زرند، دانشگاه آزاد اسلامی، کرمان، ایران Hamid Molayi Zarandi حمید ملایی زرندی 3900319475328460090215 3900319475328460090215 No Assistant Professor Department of Psychology, Zarand Branch, Islamic Azad University, Kerman, Iran استادیار گروه آموزشی روانشناسی، واحد زرند، دانشگاه آزاد اسلامی، کرمان، ایران